New approach needed to improve trans patient care

NHS care for trans patients must involve a whole-system approach to improve services, including education and training for healthcare professionals, improved NHS IT systems and access to gender identity services, according to a new position paper by the Royal College of General Practitioners.

The paper on the role of the GP in caring for gender-questioning and transgender patients recommends that the GP curriculum covers gender dysphoria and broader trans health issues – and that more training programmes should be developed to support GPs and their teams to appropriately engage with and advise trans patients.

It also calls for updated IT systems to enable GPs to treat trans patients in a safe and respectful manner, and that record codes are established for gender identity and trans status as well as biological sex.

The principles of oversight and regulation applied by the Care Quality Commission in England and equivalent bodies in Scotland, Wales and Northern Ireland should be applied to all providers of gender identity services, not just NHS services. Waiting times for gender identity clinics should be addressed and services expanded in all four UK nations.

The College also highlights an urgent need for more independent research into the effects and impact of interventions for gender dysphoria, particularly for children and young people – and the need for greater consistency around regulation of gender identity care and services, as well as greater clarity for doctors from the GMC.

Professor Helen Stokes-Lampard, chair of the RCGP, commented: "It goes without saying that GPs and our teams should treat our trans patients on the basis of need and without bias, as we would any patient. This includes being mindful of the terminology and language we use when talking to our trans patients, based on each patient's individual preference.

"It sounds simple, but there are barriers to this, not least with our current NHS IT systems that only allow us to record a patient's gender in a binary way. As well as unintended misunderstandings and the apparent lack of respect that can result from this, it also has serious health implications, for example, around referring trans patients for appropriate screening.”